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Hiding Bad Medical Care from the Public

Every day millions of Americans place their safety in the hands of doctors, but we know little or nothing about the doctor’s track record of safety. If we try to get that information, we are stonewalled. Why is that, particularly when up to 100,000 patients in U.S. die each year and many more suffer injuries due to preventable medical mistakes according to the Institute of Medicine?

There are many reasons why the healthcare system has managed to keep bad medical care secret from the public, but a primary culprit is the peer review statute that prohibits disclosure of hospital investigations.

When bad things happen to patients in hospital, hospitals are mandated to investigate the event to find the root cause. In virtually every state, these investigations are called peer review investigations and, by statute, the proceedings are kept secret from the public and cannot be divulged, even during the course of a lawsuit brought by a patient whose care is investigated.

Minnesota’s peer review statute is contained in Minn. Stat. Sections 145.61 through 145.67. Under the statute, the proceedings of peer review investigations are kept secret from the public and divulging the contents of the proceeding is a misdemeanor. The healthcare system contends that secrecy is necessary to assure that healthcare providers will tell the truth during the investigation. If the truth is told, the argument goes, the root cause of the event will be discovered and the hospital can take steps to assure that the mistake does not happen again.

Although everyone favors a hospital system that is proactive in identifying and correcting bad medical practice, the reality is that healthcare providers who provide bad care have little incentive to tell the truth in a peer review proceeding. Truthful disclosures may be shielded from public consumption, but not from hospital administrators who have the power to revoke the privileges granted to the offending healthcare provider. Under these circumstances, the healthcare provider has little incentive to make a full and truthful disclosure that may ultimately be used by the hospital to remove the provider from employment.

Also undercutting the justification for secrecy is that witnesses to the event may have little incentive to be truthful. If a doctor or other healthcare provider has their hospital privileges or credentials revoked by the hospital due to the results of the investigation, the statements made by witnesses can be discovered by the provider under Minn. Stat. Section 145.64, subd. 2. Again, healthcare providers have little incentive to be truthful if they know that their colleague can discover exactly what was said about them.

Our legislators need to reconsider whether peer review proceedings should remain confidential. We should not need laws to get healthcare providers to be honest, and the laws we have in place provide no assurance of honesty. Patients entrust their lives to doctors, and they should have the right to make an informed decision about their healthcare providers, including knowledge of the healthcare provider’s track record on patient safety.

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